Materazzi G, et al. - The purpose of this study was to report a large European experience with Robot-assisted transaxillary thyroidectomy (RATT). Findings suggested RATT as safe and effective and could serve as a viable treatment modality in selected cases.

Methods

• 257 patients who underwent RATT for nodular disease between February 2012 and September 2016 were retrospectively analyzed.
• Researchers collected data regarding patient demographics, diagnosis, ultrasound-estimated mean thyroid volume and nodule size, type of resection, operative time, postoperative pain and morbidity, and the hospital length of stay.
• Assessment of pain was performed by visual analog scale score 12 h postoperatively (on the first postoperative day, before discharge).
• The outcomes assessed included feasibility, effectiveness, and safety.
• They performed follow-up of thyroid carcinoma patients measuring thyroglobulin levels and ultrasound examination (median follow-up 24 months (6–48 months)).
• First control after 12 months and successively once a year.

Results

• Authors analyzed 257 patients comprising 253 women and 4 men; a mean age was 37.3 years.
• Indications for the procedure included benign disease in 116, papillary carcinoma in 56, and indeterminate nodule in 85.
• Findings revealed mean thyroid volume of 16.8 mL, and nodule size of 25.3 mm.
• 138 patients underwent a hemithyroidectomy and 118 underwent total thyroidectomy; mean operative time for the former was 77.5 min and for the latter was 99.7 min.
• They identified one conversion.
• In the study population, complications encountered were transient hypoparathyroidism in 7/118 (total thyroidectomy) patients (5.9%), transient vocal fold palsy in 3/257 (1.1%), 1 delayed tracheal injury (0.4%), and 3 postoperative hematoma (1.1%).
• They observed mean visual analog scale score of 1.79, and the mean length of stay of 1.6 days for hemithyroidectomy and 1.9 days for total thyroidectomy.